FDA Adverse Event
Malfunction
Summary report: N
HEARTSTART XL+ DEFIBRILLATOR/MONITOR
MDR report key: 3190869
·
Received June 14, 2013
Report
- Report Number
- 1218950-2013-02426
- Event Type
- Malfunction
- Date Received
- June 14, 2013
- Report Date
- May 23, 2013
- Manufacturer
- PHILIPS MEDICAL SYSTEMS
- Product Code
- MKJ
- PMA / PMN Number
- K110825
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- IN
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 1
(B)(4). A F/U REPORT WILL BE SUBMITTED UPON COMPLETION OF THE INVESTIGATION.
Description of Event or Problem · 1
THE CUSTOMER REPORTED THAT THE DEVICE IS SHOWING ERROR MESSAGE, "ECG EQUIPMENT MALFUNCTION." THE USER PERFORMED THE OP CHECK, AND THE TEST PASSED, ERROR MESSAGE GONE. HOWEVER RED X INDICATOR STILL REMAINS. THERE WAS NO PT IMPACT REPORTED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 272320 | HEARTSTART XL+ DEFIBRILLATOR/MONITOR | MKJ | PHILIPS MEDICAL SYSTEMS | 861290 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |